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Individual

DR. SABA V BEJANISHVILI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4460 AUSTELL RD, AUSTELL, GA 30106-1844
(770) 941-4716
(770) 941-3047
Mailing address
3875 AUSTELL RD, STE 204, AUSTELL, GA 30106-1103
(770) 819-1717
(770) 819-1140

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
052143
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
432250739C
GA
01
P00218408
RR MEDICARE
Enumeration date
01/25/2006
Last updated
12/03/2010
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